Health equity and decolonization imperative

Health Equity and the Work of Decolonization: Reflections from the MOSAIC Panel

In the wake of George Floyd’s murder, the national conversation around equity in the United States intensified—and with it, a renewed focus on health care. The disparities long embedded in the system were no longer abstract statistics; they were urgent realities demanding attention. I recently participated in a panel discussion about the film MOSAIC, which aimed to shed light on the broader picture of health equity. Through personal stories from Hispanic, Indigenous, and Black communities, the film underscored a sobering truth: despite the dazzling headlines about cryptocurrency and space travel for the ultra-wealthy, equitable health outcomes for marginalized groups have barely budged in decades.

The U.S. health care system remains deeply gendered and racialized, producing adverse outcomes for BIPOC communities. The disproportionate impact of COVID-19 on Black and Native American populations is one example. Another, as reported by the Centers for Disease Control and Prevention, is the alarming rate at which Black, American Indian, and Alaska Native women die from pregnancy-related causes compared to white women. These disparities are not anomalies—they are enduring legacies of settler colonialism and systemic neglect.

To move toward justice, we need a shift in consciousness among those working within the system. A social equity consciousness ensures that marginalized voices are not silenced or sidelined. It means recognizing Black and Hispanic women as competent agents in understanding their health and making informed decisions about their care. For health care to truly serve the goals of social justice, it must be culturally relevant—responsive to the lived realities of diverse communities.

This work requires more than reform; it demands a liberation-focused approach to health intervention. Decolonizing healthcare is a complex and ongoing process. It involves identifying, naming, dismantling, and preventing systems that harm BIPOC communities. The colonial characteristics embedded in health care—its norms, values, and power structures—have been entrenched for generations. Decolonization means exposing how the system controls, divides, disempowers, and exploits. It calls for vigilance, for an activist disposition that can imagine and implement workable solutions.

We’ve seen how exploitation in health care affects everyone. The opioid epidemic, for instance, revealed how corporate interests in overprescribing pain medication ultimately harmed people across racial lines. But the burden is not evenly shared. Marginalized communities often bear the brunt of systemic failure.

Health equity is not a trend—it’s a moral imperative. And decolonization is not a metaphor—it’s a roadmap. The journey is long, but the destination is clear: a health care system that affirms dignity, centers justice, and serves all people.